In the late 1970s, the term ‘Imposter syndrome’ was coined by Drs Clance and Imes (both females incidentally…). It referred to high-achieving people who were unable to “own” their accomplishments and who lived in persistent fear of being exposed as a “fraud”. The concept has been described frequently within the medical profession over the past few years. An eloquent example was written by #NatalieMay (stemlynsblog.org) in 2014.

Most of us have experienced it. For many of us, it will never be cured, but there may be phases of relapse and remission. In the main, I am affected at low and manageable levels these days. But then I did something a little new for me – I started writing – and I discovered a new variant.

Last week, I wrote a letter to our health service CEO, acknowledging the amazing multidisciplinary team-based care provided to a young trauma patient. I was inspired by how effortlessly and effectively different departments worked together in order to deliver high quality care in a timely manner. It was gold standard healthcare and I was thrilled to be involved in it.

So thrilled and so inspired was I that after a couple of days of reflection, I was compelled to write to our CEO. In my letter I commended the teams involved, I quoted some complimentary remarks made by the retrieval team, and I affirmed that we are well on our way to achieving our goal of being a world-class health service.

I sent off my letter by email on a Tuesday night and the CEO responded within an hour – now he was thrilled to hear about the episode of care. So thrilled was he that he asked my permission to share the letter with the Chairman of Board. The contagion of the thrill of the accomplishment was perpetuated when the Chairman forwarded the letter to the state’s Health Minister and the Director General.

Of course this is all great stuff, and there was patting of backs all round.

Don’t forget the small primary hospital who first delivered life saving care, I graciously cautioned when approached by the hospital media team: without them, there would not have been a life for us to save. The story, along with this stipulation, featured in a local publication.

“Good work”, said my boss (joining in the back patting), “We need to do this more often and celebrate our big wins”.

The thing is: the bigger the story got, the more sheepish I felt. The back being most frequently and heartily patted was mine. On the night of care, I commented to my registrar that my contribution had been minor. He generously assured me that my input had in fact been vital in priming the system for receipt of this patient in the middle of the night. (Note the coincidental gender-attached perspectives here…).

Despite this, I was acutely aware that, at the end of the day, it was the regional hospital and the retrieval team who kept the patient stable for transport to us. It was then the anaesthetist, the surgeons, and the supporting nursing and anciliary health care workers who scrubbed, donned gowns, wielded lines and scalpels, and truly saved the patient. Sure, I’d helped to align them all toward the common (and obvious) goal but then I’d stepped back and let them all get on with it – my part in this patient’s story was over.

So I then felt a bit awkward and perhaps unjust that the glory was ostensibly being awarded to me. The more I was commended, the more I shrunk into a sense of fraudulence – and having learned to manage Imposter Syndrome the “first” time, I was acutely suffering it again in a different guise.

But then I started to resolve this in my own head, and came to the reconciliation that in the global picture, I had in fact contributed to the story, even after I’d completed transfer of the patient to the operating theatre.

The week after my letter went “viral”, I happened upon the Chairman of the Board in the carpark lift shaft. I introduced myself and, aided by some pointed prompting, he associated my name with the letter. I thanked him for his recognition of the teams involved.

He responded sagely: “It was the tone of the letter. The tone illustrated the morale and the culture which I hope exist here.” He asked me some further questions about this and I told him about a tenacious sense of optimism.

It made me ponder about what he may have meant by tone. I’d like to think that there was a tone of celebration in what had been accomplished. Perhaps there had been a tone of deliberation – of carefully considering all the elements of the healthcare episode. Hopefully there had been a tone of humility also.

But I think there had been one more thing – almost intangible. I heard recently about the concept of ‘the fifth voice’. When four voices are blended in harmony (eg: a Barbershop quartet), there sometimes becomes apparent a fifth voice – a perfect illustration of the whole being more than the sum of its parts. The fifth voice in the story was the unspoken spirit of teamwork.

As the Chairman and I parted ways, I could appreciate that if not for the storyteller, the work of the heroes may never be recognized or even known. The storyteller captures and recounts the glory – so that a wider audience may see it, and hopefully be inspired by it.

And so I wrote another story – this one. We should be celebrating our wins more readily than we do – we learn as much from them as from our failures. Therefore, the next time something makes you feel thrilled (or even just a little happy) at work, go on and write it down. Even if you are not the hero – in fact especially if you’re not the hero – you can be the storyteller. Share it sideways and share it upwards. You never know what ripples you may cause.

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